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AJNR - American Journal of Neuroradiology

Publication Preview: Published April 15, 2009

American Journal of Neuroradiology 2009;30:1153.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1530

INTERVENTIONAL

A Second-Generation, Endoluminal, Flow-Disrupting Device for Treatment of Saccular Aneurysms

D.F. Kallmes, Y.H. Ding, D. Dai, R. Kadirvel, D.A. Lewis and H.J. Cloft

From the Department of Radiology, Mayo Clinic, Rochester, Minn.

Please address correspondence to David F Kallmes, MD, Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail: Kallmes.david{at}mayo.edu

BACKGROUND AND PURPOSE: We report a preclinical study of a second-generation endoluminal device (Pipeline Embolization Device [PED-2] for aneurysmal occlusion and compare the PED-2 with its first-generation predecessor (PED-1).

MATERIALS AND METHODS: Our Institutional Animal Care and Use Committee approved all studies. The PED-2 is a braided endoluminal, flow-diverting device and was implanted across the necks of 18 elastase-induced aneurysms in New Zealand white rabbits and followed for 1 month (n = 6), 3 months (n = 6), and 6 months (n = 6). A second PED-2 was implanted in the abdominal aorta to cover the origins of the lumbar arteries. Angiographic occlusion rates were documented as complete, near-complete, and incomplete. Parent artery percent diameter stenosis was calculated. Results were compared with a previous publication focused on the PED-1, with use of the same model. We compared ordinal outcomes using Fisher Exact or ² tests. We compared continuous data using analysis of variance.

RESULTS: Occlusion rates (complete and incomplete) for the PED-2 were noted in 17 cases (94%) and 1 (6%), respectively, compared with 9 cases of complete (53%) and 8 (47%) of incomplete occlusion with the PED-1 (P = .0072). No incidents of branch artery occlusion or distal emboli in vessels downstream of the parent artery were observed with the PED-2. Parent artery neointimal hyperplasia was minimal in most cases and was significantly less than in the PED-1.

CONCLUSIONS: The PED-2 is a biocompatible and hemocompatible device that occludes saccular aneurysms while preserving the parent artery and small-branch vessels in our animal model.